NHS ‘special measures’ has saved lives !

The NHS’s unprecedented decision to put 11 trusts intro special measures is likely to have saved hundreds of lives, experts have said. Death rates fell at the trusts after the 2013 intervention, spearheaded by NHS England’s medical director Sir Bruce Keogh in the wake of the Mid Staffordshire hospital trust scandal.

Although difficult to predict from mortality statistics, Roger Taylor, director of research at the Dr Foster Group, has published new analysis saying their had had been a fall of roughly 450 across the 11 hospitals between 2013 and June 2014.

Mr Taylor said it was almost certain hundreds of lives had been saved because of the intervention. However it was revealed  that at one trust, Tameside Hospital NHS Foundation Trust in Greater Manchester, mortality rates had continued to worsen.

Roger TaylorKey contributions include changes in management at the worst-performing hospitals, and the appointment of directors of improvement – an NHS equivalent of the “super heads” deployed at failing schools.

Tameside, Medway NHS Foundation Trust and East Lancashire Hospitals NHS Trust have all appointed new chief executives in the wake of the Keogh inspections into 14 NHS trusts that had “outlying” high mortality rates, 11 of which were subsequently placed in special measures.

Others replaced board members, and special measures hospitals were “buddied” with a successful neighbouring hospital.

New managers embarked on recruitment drives, appointing hundreds of new medical staff – a pattern repeated across the NHS following the damning Francis Report into the Mid Staffordshire NHS Foundation Hospital, where high mortality rates served as an ealy warning of problems.

Across all 11 Keogh trusts, annual mortality rates fell by 9.45 per cent after being placed in special measures. The hospitals are now closer to the average mortality rates. However, at two hospitals mortality rates remained flat and the rise at Tameside Hospital was being investigated.

A Thameside Trust spokesman said: “Initially we focused our attention on understanding and improving the care and treatment given to our patients. We now have a fully embedded mortality review process, where all deaths are comprehensively reviewed. We are now clearer on the data quality issues which require further action.”

Five Keogh trusts, including Tameside, are still in special measures following inspections by the Care Quality Commission (CQC) in recent months.

An enhanced hospital inspection and improvement regime was a key plank of the Government’s response to the Mid Staffs report. Ministers are hopeful they will be judged on patient safety, following criticism from the King’s Fund think tank, which concluded that former health secretary Andrew Lansley’s controversial flagship reforms had been “disastrous”. By contrast his successor, Jeremy Hunt, has portrayed himself as a defender of patient’s interest, the King’s Fund’s report said.

Responding to the findings, Health Minister Lord Howe said: “Since the [Mid Staffs]  scandal we have taken tough decisions to improve patient safety. Today’s report is further evidence that our special measures programme is working. Safety standards are iproving and lives are being saved.”

Andy Burnham shadow Health Secretary said: “It was because of this Government’s decision to axe thousands of nursing jobs that these hospitals were placed in special measures in the first place. The hospitals are still getting worse on key measures now, particularly A&E performance like the rest of the NHS. It is wrong and dangerously complacent for ministers to pat themselves on the back when the NHS is getting worse all over England.”

NHS hospital mortality rates are determined by two sets of figures – Hospital Standardised Mortality Rates (HSMR) and the Summary Hospital-level Mortality Indicator (SHMI). Factors that effect a patient’s survival chances include age, diagnosis and previous admissions, especially in an emergency. Analysts can determine what the expected number of deaths will be based on the national average. A hospitals HSMR and SHMI scores show how much higher or lower a hospital’s mortality rates are than the expected number of deaths.

Professor Edward Baker, CQC deputy chief inspector of hospitals said progress had be made at many of the original 11 Keogh hospitals. “We are impressed by the leadership shown in many of these trusts that has led to these measurable improvements in quality,” he said.

Cooper. C 2015. The Independent on Sunday 08/02/2015. p 2

“It’s sad really”

Elderly – “Illlegally Restrained in Care Homes”

Thousands of elderly and vulnerable patients are being illegally restrained by staff in hospitals and care homes, according to the care watchdog.

The Care Quality Commission (CQC) warns that carers and nursing staff are ignoring laws which state they must apply for approval before  depriving patients of their liberty.

A Care logoBut there is a “worrying” backlog of nearly 20,000 cases awaiting approval for a Deprivation of Liberty Safeguard, and staff may well be restraining patients anyway as they wait for paperwork, the watchdog said.

Care home staff go to councils and hospital staff to the NHS with the applications, nearly half of which are turned down.

There were nearly 53,000 applications in the first six months of 2014/15, a seven-fold increase compared to submissions for the entire year of 2013/14. The huge rise followed two court rulings which stated individuals could also be deprived of their liberty in foster care and sheltered housing, as well as hospitals and care homes.

“The vast majority of people working in hospitals and care homes are decent and dedicated to their profession. It’s such a shame they are “propping up”, to the best of their ability, a system overcomplicated, oversubscribed, overwhelmed and long overdue a new direction.”

Home Care Cuts – “Inhumane”

One of the main reasons there is such a crisis in hospitals is that a large number of elderly people are occupying beds because they can’t be sent home.

And the reason they can’t is that the home care system is collapsing.

There is terrible pressure on carers which leads to them having almost no time to spend with people in desperate need.

Gillian Demet has turned whistleblower because she thinks what is happening to care needs to be exposed.

She tells how she had just 15 minutes to look after each of her clients – 15 minutes in which she might, typically, have to get someone out of bed, undress them, wash them, dress them, make their breakfast, give it to them – and then dash off to do it all over again. And she worked 14 hours some days for the minimum wage.

Carer and ClientYet Gillian’s main concern isn’t the pressure she was under but the impact on her clients.

Incredibly, her boss at private care firm Sevacare, Ravi Bains, agrees with her about the inadequacy of the service. He says such short visits are unfair on carers  and those they are looking after.

Mr Bains is just as forthright in saying where the blame lies – with government cuts.

The amount spent on home care has plummeted by 25 per cent since the coalition came to power and will fall much lower if the Tories win the election.

David Cameron’s big campaign pitch is that we can’t afford to spend more. On the contrary, Prime Minister – we can’t afford to spend so little on some things, with home care at the top of the list.

This is an appalling way to treat the most vulnerable, needy pensioners.

“All of our health and care sectors are in crisis now – what on earth the future holds is anyone’s guess – but be prepared, it looks certain to get worse, if it ever gets better  –  ‘Care in the Community’, what was that?”

Sunday Mirror. 18/01/2015. P.14

POLICE CALLED TO HOSPITALS EVERY 10 MINUTES

Police are called to investigate a crime in hospital roughly every 10 minutes, shock figures reveal.

The problem is becoming so bad that several forces now base officers in some of the busiest health centres.

Police attended 64,728 incidents at NHS premises last year – up 1,700 on 2012. This equates to about once every 10 minutes, said Sky News, which obtained the figures from 30 forces under the Freedom of Information Act.

The crimes included a range of offences from theft to stabbings and rapes. Many are drink-related, said the Association of Chief Police Officers.

The scale of the crisis is likely to be much worse as the figures only cover two-thirds of forces and do not include the biggest, the Metropolitan Police.

The Royal College of Nursing called for a tougher approach to offenders by both police and hospital trusts. Chief executive Dr Peter Carter said: “Something needs to be done about this major, national problem.”

The ACPO’s national lead on alcohol harm reduction, Northants Chief constable Adrian Lee, said: “There was a time when NHS staff, through good motivations, didn’t want to report crimes against people there to receive the service. But that’s not appropriate as it sends a message you can behave inappropriately in hospital. Well, you can’t.”

Among forces now basing officers at A&E units is Greater  Manchester Police. The figures shoe it attended 12,726 incidents in 2013 – up 320 in a year.

Figures from NHS Protect in November show a record 68,683 reports of assaults on health service staff in the year to March.

Most of the bites, blows and stabbings were believed to be carried out when the hard-pressed medics were trying to attend to patients.

And senior NHS officials said many assaults were still not being reported.

Gregory, A. Cops are called out. Daily Mirror 3rd Jan 2015, p. 12.